Patients are often surprised when I recommend lithium supplements as an integrative psychiatrist, given lithium’s reputation as a medication with serious side-effects and risk of toxicity. However, low-dose lithium supplementation is a much safer treatment option with few side-effects. In fact, some patients start feeling less anxious, irritable, and depressed just days after taking low-dose lithium.

Despite the evidence supporting the benefits of low dose lithium, it is still underused as a supplement in psychiatry. This is unfortunate because lithium appears to have the potential to help many people with mental health issues.

What type of lithium supplements are available?

There are three types of over-the-counter lithium supplements:

Ionic lithium: is a liquid form that contains lithium chloride. This form can be especially helpful for children or patients who are sensitive to treatment, as it is easy to start at a low dose and build up to a therapeutic dose. Typically, ionic lithium is prescribed at 0.5 – 1mg.

Plant-based lithium: is a unique form of lithium made from vegetables that are grown in high-dose lithium soil. Currently, there is only one manufacturer who produces plant-based lithium. This form may be better absorbed and utilized, as our bodies are used to digesting lithium in plants. In my practice, some of the best reports and feedback come from patients with depression who use plant-based lithium.

Lithium orotate: is a salt with orotate, a naturally-occurring substance in the body. Patients taking lithium orotate experience far fewer side-effects compared to lithium medication. This may simply be because lithium orotate is prescribed at much lower doses than the medication. Others have argued that it can enter cells where it is needed, resulting in less toxicity to other organs.

Lithium orotate usually comes in 5mg capsules: a dose that is higher than ionic or plant-based lithium, but much lower than the medications that can contain up to 225mg of lithium. In other words, lithium orotate offers an option for those who need more lithium than the trace levels in ionic and plant-based lithium, but want to avoid the serious side-effects of high-dose medication for conditions like depression, anxiety, and brain fog.

Are lithium supplements safe? What are the side-effects?

The side-effects and toxicity associated with lithium are dose-dependent and usually only seen with high-dose medications.